Cardiovascular manifestations and electrocardiographic abnormalities have been reported among some prevalent infections in tropical regions, which lead to a great amount of morbidity and mortality. The major infectious diseases include chikungunya, dengue fever, H1N1 influenza, and coronavirus disease-19 (COVID- 19) in the viral category, leptospirosis, salmonellosis, scrub typhus and tuberculosis in the bacterial category, and malaria in the protozoan parasite category. All these infirmities constitute a foremost infection burden worldwide and have been linked to the various cardiac rhythm aberrancies. So we aimed to identify and compile different studies on these infections and associated acute electrocardiographic (ECG) changes. The search was made in online international libraries like PubMed, Google Scholar, and EMBASE, and 38 most relevant articles, including original research, systematic reviews, and unique case reports were selected. All of them were evaluated thoroughly and information regarding ECG was collected. Myocarditis is the predominant underlying pathology for rhythm disturbance and can be affected either due to the direct pathogenic effect or the abnormal immune system activation. ECG variabilities in some infections like chikungunya, scrub typhus, and leptospirosis are associated with longer hospital stay and poor outcome. Tropical infective diseases are associated with prominent acute cardiac rhythm abnormalities due to myocarditis, which can be identified preliminarily by ECG changes.

Aconitine, a plant alkaloid is a usual constituent of various over-the-counter herbal remedies and is an uncommon cause of deliberate poisoning. Herein, we describe an unusual case of poisoning in a young male due to accidental ingestion of aconitine tincture. On presentation, his electrocardiogram documented ventricular arrhythmias for which amiodarone was administered promptly. This led to considerable improvement in heart rhythm. The patient recovered gradually with this management and achieved normal sinus rhythm. He was completely asymptomatic within 5 days of treatment and subsequently discharged. Our management with amiodarone narrates the importance of this drug in aconitine poisoning, which can prove to be fatal in the absence of any intervention or delay in diagnosis. Nonexistence of specific antidote also establishes amiodarone as a standard remedy.

Syringomyelia is the development of a fluid-filled cyst (syrinx) within the spinal cord and is an extremely rare chronic manifestation of tuberculosis. The syrinx so formed may expand over time, causing compression or destruction of spinal tracts and surrounding nerve roots. Development of syringomyelia in a patient of Pott’s disease is particularly infrequent. We report this rare case of a 31-year-old man with syringomyelia as a prolonged complication of Pott’s disease.

Neurological manifestations like encephalitis, especially hemorrhagic encephalitis, are rarely described in dengue fever (DF), and the gamut may affect any part of the central or peripheral nervous system. Herein, we report two cases from Northern India, presenting with fever and altered sensorium, subsequently diagnosed with DF. Imaging studies revealed hemorrhagic encephalitis in both of them but one of them had a grave outcome, unfolding the fatal nature of the disease. The report enlightens DF as an unusual etiology of encephalitis and the importance of considering the infirmity as a differential in patients with neurological manifestations.

Amebic liver abscess (ALA) is the most common extra-intestinal manifestation of amebiasis. Its complications include rupture into peritoneum, pleural space or anterior abdominal wall. Large abscesses can cause compression of neighboring vascular structures with thrombus formation. Herein, we are presenting an unusual case of a 26-year-old male patient who presented with fever, abdominal pain, chest pain and dyspnea. Ultrasound of the abdomen revealed a lesion in the right lobe of liver and chest radiograph revealed minimal right-sided pleural effusion. A computed tomographic (CT) scan was done in view of unexplained symptoms and a diagnosis of ALA compressing the inferior vena cava (IVC) with subsequent thrombus formation and pulmonary thromboembolism (PTE) was made. He was managed successfully with antibiotics, percutaneous aspiration and anticoagulation.